STAKEHOLDERS’ PERSPECTIVES ON AN AREA AGENCIES ON AGING SERVING URBAN OLDER ADULTS

Abstract Area Agencies on Aging (AAAs) in urban areas play a critical role in helping older adults maintain and enhance their quality of life. The Detroit Area Agency on Aging (DAAA), recognizing the importance of involving Detroit area seniors and community stakeholders in long-term strategic initiatives, funded a comprehensive needs assessment of the region’s seniors. This study reports findings from an online survey in the winter of 2020, (n=94) aimed at identifying stakeholder views of DAAA programs and services. We used descriptive statistical analyses for closed-ended items and content analysis to identify themes from open-ended questions. Most respondents were either direct service purchase vendors (34.0%) or contractors (22.3%). The highest ranked perceived agency role was information and assistance (mean=2.41; SD=1.02), followed by direct service provision (mean=2.45; SD=1.52), coordination of aging services (mean=2.63; SD=1.54), education (mean=3.40; SD=1.11), and training (mean=4.10; SD=0.99). The most commonly mentioned areas needed for the region to become age-friendly were supportive community services (66.3%), public transportation (44.9%), safety and security (41.6%), available and affordable housing (40.4%), access to healthcare (38.2%), and housing maintenance/modification (24.7%). The most common themes from open-ended responses included outreach, collaboration, and promoting aging in place. These findings suggest the imperative of providing accessible, high-quality services that promote aging in place in urban areas through community outreach and collaboration activities. Detroit area seniors are a vital community resource, and ongoing stakeholder input is needed as part of collaborative efforts to meet their complex emerging health and social needs.

In intergenerational programs, people from multiple generations share their talents, build healthy social relationships, and experience improved well-being and social presence and identity (Lee et al., 2021).As a part of agefriendly community initiative in a small city in the Northeast, an intergenerational engagement community project, named "Senior to Senior", involved a multi-year partnership among community agencies, including the local Office for Aging, a university, a high school, a senior center, and a church.As part of this partnership, a community dance was held in May of 2022, where local high school students and older adults participated in a variety of intergenerational activities.This study explored how the principles of social capital are incorporated into the development of intergenerational and age-friendly communities.Using focus groups with community partners (n=6) and surveys with older adult participants (n=29), the research team sought to describe how community agencies collaborate on the development of intergenerational and age-friendly communities.Carpiano's framework of social capital (2008) guided the data analysis and the development of following themes: (a) importance of social capital identification; (b) development of social cohesion among multiple generations; (c) assessment of social antecedent for the development of intergenerational and age-friendly community; and, (d) outcomes of the community events on diverse stakeholders.The findings highlight the importance of understanding the contextual factors of each community and the agencies within, while also elucidating the necessity of stakeholder buy-in for the sustainable development of intergenerational and age-friendly communities.With over 100 million older people, India has the second largest elderly population in the world.Older people in many parts of India, especially in the rural settings live in vulnerable conditions with limited facilities and with an overall poor health status.GRAVIS has been working actively in the Thar Desert of India to address older people's health.It has multi-layered health intervention combining medical services, public health activities and research component.Self-care training is integral part of our work with older people.With help of locally designed contents, GRAVIS team trains older people on healthy ageing.The curriculum includes 10 modules focusing on basics of human body and biology of ageing, Common diseases in old age, prevention of common diseases, management of common diseases and useful information on Government health programmes.Older people in groups of 12-15 attend trainings once in 15 days.To provide service to older people and to take self care education further, GRAVIS also works with a cadre of Village based Health Workers (VHWs).The impact of our self-care training interventions has been quite positive.The trainings are well received within the community.Over 1,500 older people have been trained and over 85% report a significant increase in their knowledge levels.GRAVIS has been able to draw the attention of local health authorities and hopes that the trainings could be scaled up further.Self care and improved health knowledge are critically important for older people to stay healthy, particularly in remote and resource scarce settings.

STAKEHOLDERS' PERSPECTIVES ON AN AREA AGENCIES ON AGING SERVING URBAN OLDER ADULTS Faith Hopp, and Fay Keys, Wayne State University, Detroit, Michigan, United States
Area Agencies on Aging (AAAs) in urban areas play a critical role in helping older adults maintain and enhance their quality of life.The Detroit Area Agency on Aging (DAAA), recognizing the importance of involving Detroit area seniors and community stakeholders in long-term strategic initiatives, funded a comprehensive needs assessment of the region's seniors.This study reports findings from an online survey in the winter of 2020, (n=94) aimed at identifying stakeholder views of DAAA programs and services.We used descriptive statistical analyses for closed-ended items and content analysis to identify themes from open-ended questions.Most respondents were either direct service purchase vendors (34.0%) or contractors (22.3%).The highest ranked perceived agency role was information and assistance (mean=2.41;SD=1.02), followed by direct service provision (mean=2.45;SD=1.52), coordination of aging services (mean=2.63;SD=1.54), education (mean=3.40;SD=1.11), and training (mean=4.10;SD=0.99).The most commonly mentioned areas needed for the region to become agefriendly were supportive community services (66.3%), public transportation (44.9%), safety and security (41.6%), available and affordable housing (40.4%), access to healthcare (38.2%), and housing maintenance/modification (24.7%).The most common themes from open-ended responses included outreach, collaboration, and promoting aging in place.These findings suggest the imperative of providing accessible, high-quality services that promote aging in place in urban areas through community outreach and collaboration activities.Detroit area seniors are a vital community resource, and ongoing stakeholder input is needed as part of collaborative efforts to meet their complex emerging health and social needs.

VETERAN DIRECTED CARE: A MIXED METHODS STUDY TO INFORM SELF DIRECTED CARE PROGRAM EXPANSION FOR VETERANS AFFAIRS (VA)
Stuti Dang 1 , Erin Bouldin 2 , Wendy Hathaway 3 , Pranjal Tyagi 4 , Lauren Penney 5 , Orna Intrator 6 , and Samer Nasr 7 , 1. University of Miami, Miami, Florida, United States, 2. University of Utah, Salt Lake City, Utah, United States, 3. James A. Haley VA Medical Center,Tampa,Florida,United States,4. South Florida VA Foundation for Research and Education (SFVAFRE),Miami,Florida,United States,5. National Institutes of Health,Bethesda,Maryland,United States,6. Department of Veterans Affairs,Rochester,New York,United States,7. VISN 8,Miami,Florida,United States The Department of Veterans Affairs (VA) is shifting from institutional to Home and Community Based Services, such as the Veteran-Directed Care (VDC) program, a self-directed program in which Veterans choose services and employ their providers to avoid or delay long-term institutionalization.The VA plans to expand VDC to all VA facilities by FY2026, but factors affecting VDC expansion are poorly understood.We focused on facilitators and barriers in the seven Veterans Integrated Service Network (VISN) 8 VDC programs between May 2022 and January 2023 to inform program expansion.We used a mixed-methods approach, with surveys followed by semi-structured interviews with VA VDC staff, their partners at Aging and Disability Network Agencies (ADNAs) and VISN 8 leadership, such as lead program coordinators, using the Consolidated Framework for Implementation Research to guide the project rapid analysis techniques.We found substantial variability in the structure, size, and operations of the VDC programs reflecting challenges noted by respondents.VA staff were consistently enthusiastic about VDC's quality benefits for Veterans, however, they recommended additional staff, a dedicated VDC coordinator, and a national guidebook or standard operating procedures to streamline processes.Respondents also noted the need for more program education targeting referring providers.Unique local challenges, like the lack of available caregivers or no local ADNA, and limited local leadership support were other factors noted that could limit expansion.Importantly, Veterans were often overwhelmed by the employer responsibilities they needed to fulfill.Addressing these concerns remains a challenge to VISN 8 and national leadership.

ALZHEIMER'S DISEASE AND RELATED DEMENTIAS (SRPP) I
Abstract citation ID: igad104.0012Hospital-to-skilled nursing facility (SNF) transitions are fraught with coordination challenges, motivating selective investments by hospitals to improve transitional care practices with "preferred" (e.g.high-volume) SNF partners.Because these partners have some agency in which patients they admit, it is unclear whether Medicare beneficiaries with social or clinical complexities, such as individuals with Alzheimer's disease and related dementias (ADRD) have equitable access to these preferred SNFs.To answer this question, we use a linear probability choice model to test the differential effect of a SNF's "preferredness" on patient placement for ADRD vs non-ADRD beneficiaries.We use a 1:1 matched sample of ADRD and non-ADRD fee-for-service beneficiaries (N=76,762) to account for other primary factors affecting placement (i.e.discharging hospital, beneficiaries' home address).After controlling for SNF characteristics, the estimated effect of a SNF being "preferred" on likelihood of placement was 12.7% lower for patients with ADRD (0.092 vs 0.103 for non-ADRD; p< 0.001).Simulation results suggest that, as a preferred SNF is assumed to have an increasing percentage of a hospital's discharges, the likelihood of a patient being discharged there grows much faster for non-ADRD patients compared to those with ADRD.Our findings show that ADRD patients may have unequal access to SNFs that are receiving the most investments from hospitals in the form of transitional care improvements.Policymakers should consider systemic investments that benefit all SNF partners, not just the most preferred based on shared discharges, while also weighing the costs of dispersing these investments too broadly.

SELF CARE TRAININGS FOR NCD MANAGEMENT IN OLD AGE IN INDIA
Taylor Bucy 1 , John McHugh 2 , and Dori Cross 1 , 1.